What are the trends in opioid use over time?Among individuals applying for Social Security Disability Insurance (SSDI), a Maestas et al. (2022) Find:

…opioid use among SSDI applicants fell from 33% in 2013 to 24% in 2018. In contrast, the proportion of applicants reporting musculoskeletal injuries (often associated with chronic pain) did not change during this period.

A key question is whether opioid use leads to more or less disability claims? On the one hand, if opioids help people manage chronic pain, they may be able to keep their jobs and possibly avoid applying for disability; on the other hand, opioids are addictive and misuse of opioids may increase the number of individuals following a disability. possibility.A paper by Mestas and Sherry (2022) Look at this relationship. They used changes in healthcare providers’ opioid prescribing preferences (eg, differences in dose and duration) that could not be explained by patient-observable patient characteristics. However, this approach assumes that such cross-provider differences in provider prescribing practice are due to differences in physician preference rather than unobservable (in the data but not physicians) differences in mean pain severity between patients. Despite this limitation, the study found:

… employment and wages are lower in areas with a higher propensity for opioid prescribing. Specifically, local prescriptions for 10 additional opioids per 100 adults were associated with a 1.6% reduction in employment and a 6% reduction in average weekly wages relative to the sample mean. In addition, an increase of 10 prescriptions per 100 adults was associated with an 8% increase in SSDI filings, a 10% increase in filings mentioning opioid use, and a 6% increase in the probability of an application being allowed in initial review, relative to the mean.

These studies are summarized in the latest edition of NBER Retirement and Disability Bulletin.